LACKAWANNA COUNTY HUMAN SERVICES BLOCK GRANT ... - …

LACKAWANNA COUNTY

HUMAN SERVICES BLOCK GRANT PLAN

FISCAL YEAR 2016 - 2017

LACKAWANNA COUNTY COMMISSIONERS

PATRICK M. O'MALLEY

JERRY NOTARIANNI LAUREEN A. CUMMINGS

Appendix A

Fiscal Year 2016..2017

COUNTY HUMAN SERVICES PLAN

ASSURANCE OF COMPLIANCE

COUNTY OF: ~~CJ..W{)_\~'\Cl

A.. The County assures that services wlll be managed and delivered In accordance with the

County Human Services Plan submitted herewith, B. The Coun1y assures, in compliance with Act 80, that the County Human Services Plan

submitted herewith has been developed based upon the County officials' determination of County need, formulated after an opportunity for public comment In the County.

c. The County and/or Its providers assures that it wlll maintain the necessary eliglbllity

records and other records necessary to support the expenditure reports submitted to the

Department of Human Services.

o. The County hereby expressly, and as a condition precedent to the receipt of state and

fed~ral funds, assures that In compliance with Title VI of the Clvll Rights Act of 1964?

Section 504 of the Fede~!J3!1b.?.Qjlitatlon Act of 1973; the Age Discrimination Act of

1975; and the Pennsylvania Human Relations Act of 1955, as amended; and 16 PA

Code, Chapter 49 (Contract Compliance regulations):

1. The County does not and will not discriminate against any person because of race,

color, rellgious creed, ancestry, origin, age, sex, gender identity, sexual orientation, or

handicap In providing services or employment, or In its relationship with other

providers; or In providing access to services and employment for handicapped

individuals.

2. The County will comply with all regulations promulgated to enforce the statutory

. provisions against discrimination.

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COUNTY COMMISSIONERS/COUNTY EXECUTIVE

FY 2016-2017

LACKAWANNA COUNTY

HUMAN SERVICES BLOCK GRANT (HSBG) PLAN

COUNTY PLANNING PROCESS

? The planning and leadership team for Lackawanna County is comprised of the Executive and Assistant Director, Lackawanna County Department of Human Services, Chief Administrative Officer, Lackawanna County Department of Human Services, Administrator, Lackawanna-Susquehanna Behavioral Health/Intellectual Disabilities/Early Intervention Program and the Administrator, Lackawanna-Susquehanna Office of Drug & Alcohol Programs and the seven member Human Services Advisory Board. While the categorical program leadership serves as the core planning team, many other stakeholders are involved and have input into the process. In Lackawanna County, the planning process continuously evolves throughout the year as opposed to being limited to a once a year planning cycle.

Individuals, family members, consumer groups and community partners have an opportunity through various committees, focus groups and categorical advisory boards to have input into planning and service coordination for the human service system. Each categorical department participates in or conducts ongoing activities throughout the year that provides valuable input into the county planning process.

The Lackawanna-Susquehanna Behavioral Health/ Intellectual Disabilities/ Early Intervention Program has built a framework for the County Planning process which utilizes the expertise of various stakeholders, providers, family members, consumers, consumer groups and partners from other systems to guide the delivery of services for the Joinder.

The LSBHIDEI Program Advisory Board brings together various stakeholders with a unique understanding of the needs of individuals and families served within our Program area. Among the members of this board are County Commissioners from both Lackawanna and Susquehanna Counties, a physician, a certified peer specialist, a licensed clinical social worker, Office of Youth and Family Services Director, special education director, community representative, mental health advocate and a representative from a local university.

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The Program facilitates three (3) committees of the Advisory Board: Behavioral Health Committee, Intellectual Disabilities Committee and a Quality Council. Committees meet five (5) times per year and are comprised of consumers and family members, persons in recovery from mental illness, program staff, community partners, advocates and service providers. All committees provide opportunities for participation from a diverse cross section of stakeholders and activities are reported at Advisory Board meetings; creating the framework and content of program development and management.

The Program Office continually works on needs assessments to assist in areas where gaps in service exist. For example, the Program initiated a comprehensive employment study aimed at gaining better insight into the current service delivery system and ultimately improving employment opportunities to eligible individuals. The study surveyed 300 participants, family members, school administrators, employment providers and employers in an effort to increase opportunities for individuals with disabilities for employment within the community. The Program is developing recommendations and will be soliciting additional feedback from various stakeholders to assist in the planning process.

The Program's Quality Council is comprised of a diverse group of community stakeholders, service providers and county personnel. The Quality Council determines the strategic direction and vision for QM activities, oversees and monitors all QM activities, establishes organizational performance indicators, reviews trends and recommends actions as necessary, recommends Program performance improvement activities and evaluates the effectiveness of Program-wide quality improvement initiatives. During the 2015-2017 QM Planning Cycle, the Program partnered with the Office of Youth and Family and Drug and Alcohol Program to develop shared human service objectives.

In addition to a Quality Council, the Program developed a Provider Quality Council which is made up of representatives of our service providers as well as LSBHIDEI Program staff members. This committee offers Providers the opportunity to discuss current trends, issues and topics in an effort to communicate and collaborate on issues effecting individuals served and their family members. This group is dedicated to devise and implement quality standards that address local needs through implementation of heightened standards of quality in service delivery.

As part of a continuous quality improvement initiative of service satisfaction, the Program conducts annual focus groups along with its HealthChoices Partners. Focus groups solicit vital information from the public about access, service satisfaction and quality.

The Program's Local Interagency Coordinating Council (LICC) has active participation from a variety of community stakeholders including families, county personnel,

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intermediate units, school districts, Early Intervention providers, the local Head Start Program, service coordinators and health care agencies.

The Lackawanna/Susquehanna Office of Drug and Alcohol Programs (the Program) conducts, and participates in, year round meetings, committees, work groups, and initiatives that attempt to problem solve gaps in services and funding constraints while effectively managing and coordinating a comprehensive substance use system of care. Program efforts are inclusive of individuals with lived experiences, family members, providers, system partners, and vested stakeholders within the community. Program representation on advisory boards, provider meetings, and various County wide committees is meant to offer and solicit feedback pursuant to the local system of care and, ultimately, enhance and transform the system so that more lives can be restored through the change process of recovery.

The Program holds a monthly meeting for the provider network in Lackawanna and Susquehanna County. These meetings are an opportunity to communicate and coordinate current trends and topics that effect the substance use system of care. Regular updates about State initiatives, budgetary issues, and legislation are provided to the group in an effort to maintain a well-informed network of substance use treatment providers. Also, Program and provider updates are communicated in an effort to engage and collaborate around local issues. Similarly, the Program conducts six (6) Advisory Board meetings throughout the year that provides related information. The Program's Advisory Board is comprised of individuals in recovery, family members, professionals in the field of substance use, and interested community members.

The Lackawanna County Criminal Justice Advisory Board and the Lackawanna County Reentry Committee are two County-based groups that meet monthly in an effort to better serve individuals in the criminal justice system. The Program is an active participant at both of these meetings and provides routine updates pursuant to the substance use system of care. The information shared at these meetings has enabled the Program to collaborate with other agencies on initiatives that strengthen both the criminal justice system and substance use system.

Lackawanna County's Pretrial Initiative is a new court venture that has taken shape this year. In September of 2015 the Lackawanna County Judiciary and the Lackawanna County Department of Human Services forged a work committee tasked with the creation of a pretrial services program. Members of the committee include: the Lackawanna County Judiciary, Lackawanna County Department of Human Services, Lackawanna County Office of Youth and Family Services, Lackawanna/Susquehanna Office of Behavioral Health / Intellectual Disabilities / Early Intervention Programs, Lackawanna/Susquehanna Office of Drug and Alcohol Programs, Lackawanna County Adult Probation and Parole, Lackawanna County District Attorney's Office, Lackawanna County Public Defender's Office, and Lackawanna County Court Administration. Pretrial

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services intend to reduce inmate population, provide bail supervision, and offer community based services, to individuals, at earlier stages in the criminal justice process.

Through local implementation efforts of a Recovery Oriented System of Care (ROSC), multiple focus groups, survey initiatives, and town hall meetings were provided throughout the course of the year to solicit feedback from the general community, persons with lived experience, and family members about the substance use system and service delivery, specifically. In addition to conducting formalized focus groups and administering comprehensive surveys, the Program promotes guided conversations regarding topics such as, recovery management; multiple pathways; chronic care system of services; medically assisted treatment; peer based recovery support services; funding opportunities; provider development; and family engagement. The information discussed and the feedback received is incorporated into the ROSC strategic plan that is currently in development.

In addition to focusing on service needs and funding issues, the Lackawanna County Office of Youth and Family Services also focuses on receiving input on the quality and effectiveness of their programs. Representatives of this agency meet monthly with foster parents to discuss ongoing issues with stability and well-being. As part of the Child Welfare Demonstration Project, agency data is being analyzed by the University of Pittsburgh and Chapin Hall to provide the agency with outcomes on the effectiveness of their programs. For the past several years, the Lackawanna County Office of Youth and Family Services has participated in the Quality Service Review (QSR) which includes the general public in various focus groups to discuss the effectiveness of agency programs. In addition to onsite licensing and inspection the agency will continue to participate biennially in the QSR process.

Representatives from the various human service categorical programs are also members of the Center for Family Engagement, Interagency Council, Continuum of Care and the Housing Coalition which meet at varying intervals throughout the year. In addition, the Executive Director of the Lackawanna County Department of Human Services is the Chair of the Northeast Behavioral Health Care Consortium (NBHCC), the Health Choices Managed Care Program for Lackawanna, Luzerne, Wyoming and Susquehanna Counties. Additionally, the Lackawanna County Department of Human Services and its categorical agencies maintain close working relationships with the PA Department of Human Services, the Scranton-Lackawanna Human Development Agency and the United Way of Lackawanna/Wayne Counties.

These various boards, focus groups and committees have diverse membership in addition to county representation. All input received through these forums is brought to the attention of the appropriate categorical department head and ultimately to the human services executive director for further research, evaluation, discussion and consideration in the planning for services.

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The Human Services Block Grant Plan is developed by the Executive Director, Human Services and the core leadership team based upon a comprehensive system review in addition to the input received throughout the year from the above referenced sources, input received at the two public hearings, review of county and program data, expenditure and service levels from the previous fiscal year as well as identified emerging trends and increased need among programs.

? In addition to the above ongoing opportunities for participation in the planning process, the stakeholders along with the general public were given the opportunity to provide input into the planning process at two public hearings. An announcement of the hearings was published twice in the legal section of the Scranton Times and the Susquehanna Independent, local general circulation newspapers in Lackawanna and Susquehanna Counties and was posted on the Lackawanna County website.

For providers, consumers, family members, etc. who were unable to attend either of the hearings, the option was available to submit written comments via mail or email to the Lackawanna County Department of Human Services.

? Across various categorical program areas every effort is made to provide services in the least restrictive setting appropriate to an individual's needs. In the Behavioral Health/Intellectual Disabilities Program numerous strategies are implemented to support service recipients in gaining access to the most integrated setting including the choice of willing and qualified providers and developing capacity across systems to address complex support needs (ex. dual diagnosis). Procedures are also implemented to divert services and supports to lower levels of care when indicated; including the incorporation of natural supports in the planning process. Funds will be allocated in Behavioral Health to provide outpatient and partial hospitalization services in place of inpatient services where appropriate. Targeted case management, community residential, housing and family support services will be utilized to assist individuals in accessing services that enable them to reside within the community. Also, Community Hospital Integration Project Program (CHIPP) funding will assist with the discharge of individuals from the Clarks Summit State Hospital to community settings. The Intellectual Disabilities Program will allocate funding for Case Management, Community Residential and Community Based Services to offer services in the least restrictive setting.

The Lackawanna-Susquehanna Office of Drug and Alcohol Programs offers a full continuum of care to individuals of all ages who are in need of substance use treatment services including: outpatient counseling, intensive outpatient counseling, partial programming, halfway house, non-hospital detoxification, non- hospital inpatient rehabilitation (short term / long term), hospital based detoxification, hospital based rehabilitation, medication assisted treatment, case management and recovery support.

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The method by which the Program determines clinically appropriate levels of care for individuals is the central organizing component, which legitimizes its coordinated approach. Specifically, the Program's Case Management Unit administers comprehensive screenings and standardized level of care assessments. Individuals who seek Program funding must demonstrate that they are uninsured and income insufficient while meeting the clinical guidelines for a particular level of care, as specified by the Pennsylvania Client Placement Criteria (PCPC III) for adults and the American Society of Addiction Medicine (ASAM) Criteria for adolescents. A liability determination is administered by the Program's Case Management Unit in order to effectuate access to treatment services. Once eligibility is determined and authorization granted, the Program works closely with its contracted provider network for referral and placement into substance use treatment services.

The Office of Youth and Family Services will allocate Human Services Block Grant funds for truancy, housing and visitation which will reduce the number of children in out of home placements in Lackawanna County. Additionally, funds will be allocated for Family Group Decision Making and Family Team Conferencing which includes input from family members and provides for a more familiar placement setting.

? Within all program areas, with the exception of Drug & Alcohol, the programs in developing their FY 2016-17 Human Service Plans are continuing spending levels based on existing allocations from the commonwealth. The availability of funding will be closely monitored during the year and adjustments will be made to provider allocations based on spending patterns and changing needs.

Throughout the course of the year, the Lackawanna-Susquehanna Office of Drug and Alcohol Programs observed multiple funding opportunities that offered extended lengths of stay in residential and halfway house services as well as medically assisted treatment for individuals. The Program continues to make every effort to partner or otherwise pursue these funding opportunities as the identified gaps in services are realized at a local level. For the upcoming year, the Program intends to redirect a considerable amount of its allocation to treatment based programming as a direct result of the heroin and opioid epidemic affecting the area.

Lastly, Medicaid Expansion and the Affordable Care Act have had a significant impact on individuals who are now "newly eligible" for health care coverage. At a regional level, the Northeast Behavioral Health Care Consortium observes 27,000 new members in the HealthChoices program. Accompanying this rise in membership is a stark demand for inpatient residential substance use treatment services. Concurrently, Medicaid Expansion has had significant cost savings for the Program and has enabled the Program to manage its allocation with greater flexibility while fulfilling the local needs of the community. Cost savings are being redirected and utilized to promote Medically Assisted Treatment, extended stays in appropriate care settings, and halfway house services.

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